HESI RN
HESI Leadership and Management
1. A healthcare professional is reading a physician's progress notes in the client's record and reads that the physician has documented 'insensible fluid loss of approximately 800 mL daily.' The healthcare professional understands that this type of fluid loss can occur through:
- A. The skin
- B. Urinary output
- C. Wound drainage
- D. The gastrointestinal tract
Correct answer: A
Rationale: Insensible fluid loss refers to the fluid lost from the body that is not easily measured, such as through sweating and respiration. The skin is a major contributor to insensible fluid loss due to evaporation of water through the skin. Choice B, urinary output, represents measurable fluid loss through urine excretion. Choice C, wound drainage, is a measurable form of fluid loss that occurs externally from a wound. Choice D, the gastrointestinal tract, primarily involves fluid loss through feces and is also a measurable form of output. Therefore, the correct answer is 'A: The skin,' as it is the main route for insensible fluid loss.
2. Which advice is most beneficial for a new nurse manager?
- A. Strive to embody the manager your staff desires while also aligning with your administration's expectations.
- B. Keep in mind that it may take 6 months to feel at ease in a new role.
- C. Begin by mentoring other novice nurse managers.
- D. Participate in substantial personal growth endeavors.
Correct answer: B
Rationale: The most helpful advice for a new nurse manager is to understand that it can take up to 6 months to feel comfortable in a new position. This allows the individual to manage their expectations and give themselves time to adapt to their new role. Choice A may be overwhelming and could cause conflicting priorities for the new nurse manager. Choice C, while valuable, might not be the immediate focus for someone new to the role. Choice D, although important, may not be as time-sensitive as the adjustment period in the new position.
3. Which of the following describes an effective method of communication?
- A. A unit manager meets with a new nurse to discuss what is going well and areas for improvement.
- B. A unit manager meets with a new nurse to explain departmental policies.
- C. A unit manager meets with staff after several safety events to introduce new policies aimed at preventing further safety events.
- D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.
Correct answer: A
Rationale: Choice A is the correct answer because it describes an effective method of communication where a unit manager meets with a new nurse to discuss what is going well and areas for improvement. This approach fosters open dialogue, provides constructive feedback, and promotes professional growth. Choice B is incorrect as it only involves the explanation of departmental policies without engaging in a two-way communication process. Choice C is incorrect as it focuses on policy introduction after safety events rather than individual feedback. Choice D is incorrect as it involves discussing safety events with another manager and policy improvement, but it does not directly address individual performance feedback, which is essential for effective communication and professional development.
4. When caring for a male client with diabetes insipidus, what does Nurse Juliet expect to administer?
- A. Vasopressin (Pitressin Synthetic)
- B. Furosemide (Lasix)
- C. Regular insulin
- D. 10% dextrose
Correct answer: A
Rationale: The correct answer is A: Vasopressin (Pitressin Synthetic). Vasopressin is the treatment of choice for diabetes insipidus as it replaces the deficient antidiuretic hormone. Furosemide (Lasix) (choice B) is a diuretic and would exacerbate fluid loss, making it inappropriate for diabetes insipidus. Regular insulin (choice C) is used for diabetes mellitus, not diabetes insipidus, which involves water balance rather than glucose regulation. 10% dextrose (choice D) is used to treat hypoglycemia, not diabetes insipidus.
5. A client with DM is preparing for a foot care exam. The nurse should advise the client to:
- A. Wear loose-fitting shoes to protect the feet.
- B. Apply lotion to the tops and bottoms of the feet to keep the skin moist.
- C. Avoid using a heating pad to prevent burns on the feet.
- D. Avoid using sharp instruments to trim the toenails.
Correct answer: D
Rationale: The correct answer is to advise the client to avoid using sharp instruments to trim the toenails. This is crucial because using sharp instruments can lead to injuries such as cuts or wounds, increasing the risk of infections, especially in clients with diabetes who have decreased sensation in their feet. Choice A is incorrect because tight shoes can restrict circulation and increase the risk of pressure sores. Choice B is incorrect because applying lotion between the toes can create a moist environment, leading to fungal infections. Choice C is incorrect because using a heating pad can lead to burns, which can go unnoticed due to decreased sensation in diabetic feet.
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